Individual
MR. TIMOTHY RAY WALENDZIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
13911 LAKESHORE BLVD, UNIT 102, HUDSON, FL 34667-7102
(727) 869-3803
Mailing address
1248 JASMINE LAKE DR, TARPON SPRINGS, FL 34689-5264
(727) 934-2981
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MA 47444
FL
Other
Enumeration date
01/16/2007
Last updated
07/08/2007
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